Provider Demographics
NPI:1497069751
Name:BAHNA, SOUBHI (MD)
Entity Type:Individual
Prefix:DR
First Name:SOUBHI
Middle Name:
Last Name:BAHNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 LOMITA BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5116
Mailing Address - Country:US
Mailing Address - Phone:310-257-7298
Mailing Address - Fax:310-598-3119
Practice Address - Street 1:2841 LOMITA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5116
Practice Address - Country:US
Practice Address - Phone:310-257-7298
Practice Address - Fax:310-598-3119
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146411207R00000X
MO2013018546208M00000X
CAC169946207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist